Obesity surgery appears safe in heart patients

Gastric bypass surgery (also known as bariatric surgery) can be a safe operation for obese patients with heart disease, provided they receive a proper evaluation before the surgery, a new study shows.

In fact, gastric bypass surgery, which makes the stomach smaller so patients can eat less, and cuts out a long stretch of small intestine so fewer nutrients are absorbed, can lead to substantial improvements in Heart disease risk factors, according to the study.

In their study, bariatric surgery was “about as safe” for patients with Heart disease as it was for patients without heart disease, said lead author Dr. Francisco Lopez-Jimenez, from the Mayo Clinic in Rochester, Minnesota. Moreover, for the Heart disease patients, “the operation was associated with an impressive improvement in heart disease risk factors,” he said.

Gastric bypass surgery is one type of procedure that can be used to cause significant weight loss if you are very obese. The surgery reduces your body’s intake of calories. Calorie reduction is accomplished in two ways:

1. After the surgery, your stomach is smaller. You feel full faster and learn to reduce the amount that you eat at any given time.
2. Part of your stomach and small intestines are literally bypassed (skipped over) so that fewer calories are absorbed. Unfortunately, sometimes nutrients are lost as well.

The surgery is only right for you if you meet certain strict criteria described later in this article.

The Mayo team compared the safety and effectiveness of gastric bypass in 52 obese heart patients and 507 obese patients without heart disease.

None of the patients died in the hospital, the report indicates. The rate of cardiac complications in the heart disease group was 5.8 percent, higher, but not significantly different than the 1.4 percent rate seen in the non-heart disease group.

After about 2.5 years of follow up, the heart disease group showed a significant drop in body mass index and blood pressure as well as levels of total cholesterol, “bad” LDL cholesterol, triglycerides and HbA1c, a measure of blood sugar, investigators report in the Mayo Clinic Proceedings.

Weight Loss Surgery: Bariatric Surgeries
There are many different types of Bariatric surgeries available. Here are some examples of surgeries that have become more popular.

     
  • Restrictive procedures that decrease food intake.  
  • Malabsorptive procedures that alter digestion, causing food to be poorly digested and incompletely absorbed so that it is eliminated in the stool.

For more information check: Weight Loss Surgery: Bariatric Surgeries

As with any operation, for bariatric surgery to be successful, heart disease patients must receive an appropriate preoperative evaluation by an internist or cardiologist, Lopez-Jimenez emphasized. There may be some patients, he acknowledged, with severe heart disease that are not suitable candidates for bariatric or any other type of surgery.

SOURCE: Mayo Clinic Proceedings September 2005.

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Revision date: June 14, 2011
Last revised: by Amalia K. Gagarina, M.S., R.D.